Making Headway Autumn/Winter 2014

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Making Headway is published byInsideThe Neuro-Rehabilitation Strategy? 2Telling Tales: Joan’s Story 3Making the Most out of Community Living 4To The Top of the World 6ABI Ireland’s Community Based Neuro-Rehabilitation Services 8Rehabilitation of Executive Function after Brain Injury 11

Autumn/Winter 2014 Edition

MAKINGBringing positive change in the lives of those affected by Acquired Brain Injury

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Making Headway is published by InsideIntroduction to Autumn/Winter Edition 2From Paris to Nice 3Using Mindmaps to Remember 5Brainstorm 8Headway Men’s Sheds 9Research Round-Up 10

Headway is accredited by CARF International (www.carf.org) for Adult Home and Community and Vocational Services (Brain Injury Speciality)

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Minister Kathleen Lynch officially opened our Dublin premises in Blackhall Green earlier in the Autumn. As she (rightly) remarked on the importance of good buildings to provide a good environment for recovery, I also reflected on some other factors that contribue to our clients’ progress.

One thing our clients tell us consistently is that the knowledge that they are not the only person facing the same mental, physical and emotional challenges is hugely important. There is a comfort in meeting other people who have experienced the same difficulties. This peer support is often the launch pad for confidence and belief as someone progresses in their recovery.

Many of the stories in this edition of Making Headway echo the importance of peer support. In a policy culture that is dominated by the need to provide person-centred services, we must ensure that we remember the power and significance of the group. Our challenge is to do this without losing sight of each person’s individuality and particular needs.

The award to Headway of maximum three year accreditation for Home and Community and Vocational services from international rehabilitation accreditation agency CARF, suggests that we have that balance in our services right, for now at least. I know that Headway, with the commitment of its staff and clients alike will not be content to sit on its laurels but will continue to look for ways to improve and innovate . I look forward to 2015!

Kieran

A Message from the Chief ExecutiveFront Cover picture: (Top L to R): The Tour de Force cyclists in California; Kieran and Sara at the Men’s Shed Conference; Ringsend Men’s shed project; Headway Mural; Liz Comerford;

So many people have gone to extraordinary lengths in recent times to support Headway brain injury services. These are just a few of the people we would like to thank:

Three epic cycle trips by the Equinox Charity Cycle Riders, Liz Comerford in the Paris 2 Nice and the Gardai involved in the Tour de Force – Thanks one and all!

Irene and DoneDeal.ie for their generous donation to support Headway as one of their chosen charities of the month. The wonderful team at Northern Trust, who continue to be a fantastic support and helped us with a dedicated team of volunteers at our summer Barbeque.

All the Cork city half marathon runners!

Dan Garry and Tony Connolly who organized our Limerick Golf Classic which brought in over €6000. The Hurley Hoey committee raised €5,700 for Headway.

Hair Affair Limerick raised €1000 for Headway and the Wings Golf Classic also raised €1000.

Thanks also to Eurospar, Moyross Limerick who have supported us with bag pack collections over the year.

Thank you Thank you Thank you!

Making Headway Autumn/Winter 2014Stories, submissions, comments and feedback are all welcome to me at [email protected]. Happy Reading!

Richard Stables, Editor, Making Headway

Kieran Loughran with Minister Kathleen Lynch

The Equinox Cycle Riders who went all the way from Clontarf to Youghal in a day!

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When you first came across the Paris-2-Nice trip, did you ever imagine you’d be able to cycle 700k?At the beginning of this year, I decided that I was going to give back to society in some way. Then I saw that you could sign up for Paris-2-Nice which seemed lovely - because I really like France and also because I could do it for Headway. Because of my own experiences I wanted to give back to people who weren’t as lucky as I was after brain surgery.

Do you want to say a bit about what happened to you?I was playing a rugby match in april 2010. I got a head knock, but I played on which was quite unwise at the time but when you’re in the thick of it...I was seeing stars.

So you were concussed?Absolutely, my head hit the ground which was pretty much like hitting concrete because it hadn’t rained in 2 months. After the game I had a seizure. We were warming down, I started making funny noises, I started acting strangely and then I just hit the ground. I don’t really remember the seizure or after it. I think I stopped breathing for a little while. They put me in recovery, brought me to the hospital, where I had a CT scan.

They kept me in for a few days just to keep an eye on me. The scan came back and there was a shadow on part of my brain. They just figured that it was a contusion so I was let out of hospital. Then they brought me back a few weeks later for another scan and it turned out that on that scan, the same shadow was in the same place. And then they brought me back again for a third scan. Eventually I was sent to a neurosurgeon in Beaumont who sat me down and said “I think you have a grade 2 oligodendroglioma”.

Did you know what that was?I figured it was a tumour - my background is in science. I was advised that he would keep an eye on

it. He said that it would develop into grade 3 and at that stage then it would be malignant. So he gave me a choice of a biopsy or taking it out. As far as I was concerned getting a biopsy was the same as surgery so I just told him to remove it.

So now four surgeries later, my tumour is gone, and I have a plate in my skull where they removed some bone. My last surgery was two years ago.

You have been through a lot.

I actually felt like I had a very good support network. But after my surgery I was exhausted. I had to sleep more. Even months later.

Back to the trip - have you always had interest in cycling?No! I haven’t at all - cycling through the vineyards in France, I thought: that would be terribly lovely, but I wasn’t thinking about what I was taking on. I used to cycle when I was a kid, and I was fairly confident of my ability on a bike. Also, I guess I stayed fit even through my surgeries so that my recovery would be quicker and without too many complications. So I thought, yeah sure, it will be grand - 700kilometres! - That really didn’t come into my head at all! I didn’t really add up in my head that it was the same distance from my home in Kilkenny to Dublin every day for six days!

Did any of the after effects from your surgeries play any part in your training?The exhaustion. In February I was chronically fatigued. I couldn’t get out of bed I was just exhausted all the time. So I went on a major detox and diet. I eliminated sugar entirely. I eliminated a lot of wheat any high starchy foods were gone, so pasta rice potatoes, sweet potatoes even root veg - anything that could in any way increase my blood sugar levels. It was a kind of ketogenic diet, to make sure that I had plenty of fats on board to help with my brain.

From Paris to Nice

Liz Comerford recently completed an epic cycle ride across France from Paris to the southern resort of Nice. Covering 700km in six days, she talked with Richard Stables about her brush with life-changing brain surgery, the trip and the challenges she overcame on the way to raise nearly seven thousand Euros for Headway.

Making Headway Autumn/Winter 2014

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Did the diet help you gain energy?Massively. But it was really difficult; I’m not going to lie. Because I spent every evening cooking instead of socialising or watching TV.

Then I did the ring of Kerry cycle in July. And that gave me THE biggest kick up the behind I’ve ever had in my life! I left Killarney at 7am and I finished in Killarney at 7pm. I was 9 hours on the saddle, which I’ve never ever done. I’d taken just three one-hour breaks. I was exhausted. Coming into Kenmare I thought “I’m never going to make it to the end...” and then I got some coffee and some nice healthy food. I got up Molls gap and got into Killarney. I think that was mentally the best thing for me. Because I got over Molls gap, both literally and figuratively. That actually got me training.

Did you come out of that thinking “yes I can do Paris to Nice”?Yes, but I realised I needed to train. Previous to that I’d done all of about 20km. So I started to go out on the Sunday spins with the Paris-2-Nice crowd.

The Paris-2-Nice crowd were really helpful. There was constant talking and encouragement, especially for me because I was a beginner. They were amazing. There was a guy who’d lost his son two years ago to suicide. Then there was another man with a child with cystic fibrosis. There was a visually impaired lady. So everyone had a story. Everyone had a reason.

Did that generate good camaraderie?Absolutely. There were 85 of us, in groups of 8 to 10. You were grouped based on your ability. Everyone was so friendly. They would look after you if you having a bad day or a bad morning. There were some days that were really tough. You could do it because there were people there to support you. People and friends help you get through it.

I remember day three was a lovely climb. Day three was lunch in Sancerre which is fabulous! I wish I could have stayed in Sancerre! But we had to go and cycle another 70k.

As time went on, you must have been growing in confidence?I definitely got fitter as I went along. After day 2, I’d taken a couple of protein shakes and I just lay in bed and fell fast asleep. I couldn’t go to dinner, I couldn’t get up. We were up at half five the next morning.

You arrive in Nice, you see the finish, what was that like?There were so many emotions! My mum and my sister came out to meet me. My mum had been out of her mind with worry the entire way. A couple of weeks before she’d been asking “are you sure you want to do this, are you ok to do this?” But I’d got my bloods done just to make sure they were all ok, I wasn’t going to take any stupid risks.

Before we got into Nice, we all met about 5k outside. Everyone joined up together. It was madness! We had to pass by the airport, we practically stopped traffic. When we came into the Promenade des Anglais it was cool - there were loads of supporters – family and friends. That was nice, because without their support it wouldn’t have been possible. It definitely wouldn’t have been possible without their support.

What are you taking away from the experience?That I can cycle 700 kilometres!

When you’re struggling, you’re saying “I can’t do it I’m too tired, you have to stop”. So it’s about finding something within yourself, to help you keep going. Doing it in a group was helpful, but there are parts of it you still do on your own. And you still kind of battle away on your own.

There were a couple of people who seemed like they were superhuman fit and I heard them talking on the phone saying “God, that was so hard today, I’m just finding this really tough” and that gave me a lift, like “I’m not alone, someone else is fighting this battle as well and we will all get there”.

So it was an amazing experience. People are really supportive and the support I got from everyone really blew me away. That support from people that I didn’t realise was there. Most definitely it blew me away.

Because of the past four years and what I’ve had to try to overcome, I still feel like I’m struggling. Some days more than others. And some days are great. I have energy, I’m so lucky that I could do that. That’s one thing I won’t dispute, that I am really lucky. But at the same time little things kind of get to me, like I can’t drive for example. I would have been very independent. But it always comes back to the fact that I was really lucky that I could do this and I could give back.

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I get from people comments like “Oh you were amazing, you went on that cycle” and I can go “Thanks” - It’s kind of sinking in – really slowly. At the same time, I think going forward it will most definitely help me with any future challenges because I know I can overcome them.

I’m sure your story will also be an inspiration to other people. I hope so. Recovery can be a difficult road and it may be longer for some people than others.

But anything is possible! If you do put your mind to

it and you keep believing that you will be able to overcome, then I think anything is possible – So many people have demonstrated it. I’m sure that many of the Headway clients have demonstrated that they can overcome things. It’s not always Paris-2-Nice for someone. Even being able to walk, or speak, that’s massive when someone’s completely written you off. I see these inspirational stories every day.

They inspire me so. I hope I inspire someone else.

Thank you, Liz

Memory problems are very common following an acquired brain injury. People can have difficulty remembering names and faces. They might forget parts of conversations they have had earlier in the day or they may find it difficult to learn and remember new information or events.

This is because memory is a complex system involving several stages. Information is first of all processed, then it is stored and then it is retrieved when we need it. Memory processes can be easily damaged as they involve many different parts of the brain and some specific structures within the brain. An injury to any one of these structures can lead to memory impairment.

There are many strategies that you can use to help make up for memory difficulties after a brain injury.

These include diaries, calendars, post-its, electronic reminders and even smartphone apps. Mindmapping is another strategy which is useful for organising and remembering information. Mindmaps were made popular by Tony Buzan in the early 1990’s. They are colourful and use both pictures and words to help you to remember information. Using pictures and words accesses both your visual memory and your auditory memory and this helps to improve your chances of recall, if one type of memory has been affected more than the other.

Drawing a mind map also involves actively organising the information that you want to learn which can lead to deeper processing of the information in your memory. They can be used to help you remember anything from a shopping list to your family’s birthdays.

Using Mindmaps to RememberBy Caragh Hesse Tyson, Assistant Psychologist

You’ll need: n A blank unlined piece of white paper (size A4 or

A3)n Some colourful pens or pencilsn Your brain.

Step One- Start with a picture in the middle of the page which represents the subject of your mindmap, it doesn’t need to be a work of art! The first thing that pops into your head may be the best. For example, if you’re making a mindmap of your family’s birthdays, the central image could be a birthday cake.

Step Two- Draw thick curved branches coming outward from the central image for each of the topics in your mind map. For example, if you were remembering a recipe, each branch could be a different step involved in the recipe. Use a different colour for each topic.

Step Three- Name each of these topics and/or draw a picture to represent them. Try to use only one or two words to name a topic as this will help you to come up with more connected ideas than a full sentence would. (continued over page)

So how do you make a mind map?

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Step Four- For each of the main branches, draw smaller connected lines spreading outwards like the branches of a tree. Add more information to each of these branches and use pictures if possible. These smaller branches represent the details of your topic.

Step Five- Underline and highlight key words in your mindmap. Add pictures if you can, the more

memorable they are- the better. For example, if you were trying to remember someone called Marcus, you could draw a picture of some colouring markers.

Step Six- Use your map! Read over and revise your map. Repetition will help you to remember. Add branches or details at a later stage if you want.

Resources and references:

Buzan, T., & Buzan, B. (1993).The mind map book. London: BBC Books.

For more detailed guides and some examples of mind maps n thinkbuzan.com/how-to-mind-map/ n www.mindmapping.com

The Headway Mural, now hanging pride of place in the Dublin centre in Blackhall Green was made by clients in the Art Group and facilitated by Kieran McCullagh, Community Reintegration Officer. The clients identified the theme of “Putting everything back together, piece by piece”. Thanks also to Dulux for the paint donation.

Headway Mural

I looked the same to my family and friends. But I knew after two strokes and a long stay in hospital that my brain was not functioning as it was prior to my stroke. Except for a limp, I looked the same and people’s expectations of me were the same. The very helpful medical team had done all they could with scans, physiotherapy etc. So with a lot of medication prescribed, I was on my own.

I had all my senses but the confusion in my head took over my life. Now, I no longer had choices as my brain would not allow it. My ability to

concentrate and my short term memory were both affected and I became lost in the company of my friends - trying to keep up but unable to cope. I also couldn’t deal with shopping in large supermarkets, not remembering my children’s birthdays and not taking in what my husband was telling me. I was so frightened and lost.

My immediate family were so supportive but were limited in their understanding of brain injury and didn’t really understand what I was going through. My GP recommended Headway. That was a turning

Walking to Wellness | By Patsy Reale

A short documentary film, “My Way”, produced by the clients of the 2013-14 LTI Cork programme, was selected to appear in this year’s Cork International Film Festival. Appearing as part of the Arts and Mind selection of shorts and talks, the film screened in the cinema at Triskel Christchurch. The film looks at the journey undertaken by adults affected by brain injury and is a moving and uplifting tribute told in the words of Headway clients. Filmed with the help of Dublin-based filmmakers and editors Paddy Cahill and Trevor Furlong, “My Way” was made possible with funding from Cork County Arts office.

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point in my life as it prevented me from slipping into depression and gave me the tools necessary to cope with my limitations. It opened the curtains to my future. I now had a clear vision of how the brain works and the areas of my brain that were affected. After two years in Headway Limerick, attending weekly brain injury management and other motivational groups, I was ready to face the world. Yet I was aware of my extra weight that was causing me concern due to breathing problems after any exercise. I knew I had to make a start yet there was never the right time. Then it was announced at Headway that Ray Darcy was heading up a 5km walk

in Limerick, and all clients were encouraged to give it a go. I agreed, not expecting to finish.

So, with our blue Headway T-Shirts distinguishing us from the hundreds competing we set off for the starting line. After a special mention from Ray on the stage, we were all set to go. Here was my opportunity to embark on an exercise routine, get moving and get fresh air into my lungs.

I did finish, and felt a great sense of achievement at the finish line. I felt happier and healthier and I knew that a more active life style was my goal. With the encouragement from the staff at Headway I returned to swimming for the therapeutic benefit. I have also started to plan my meals ahead of time and keeping a food diary to help me plan my meals.

I sincerely thank Headway, not only for helping me understand and manage the difficulties I faced after my brain injury, but also for the encouragement to improve my overall health and giving me back the ‘feel good’ factor!

Table Quiz The clients attending the Day Rehabilitation Service in Donnybrook on Wednesday mornings hosted a table quiz in September at the Dandelion Bar on St. Stephen’s Green. This is the second year that the group organized a fundraiser table quiz. The planning took place in the Donnybrook centre and took a lot of deliberation. The organisation of this event was a great exercise to put into practice the client’s organising and planning skills in a fun and meaningful way. The group managed to raised 1,262 Euro to help to fund the Headway Annual Art Expo. Thank you to all clients, and family members involved in the project: Nick Boland, Pat Kearney,

Attis Ateka, Marion Gaule & Houric Cedric. A particular thank you goes to Christine Gara and Alan Fenton for going the extra mile to obtain so many raffle prizes!”

Cork Film Festival

Patsy (front, in white trousers) with Ray Darcy and the Walk with Ray crew

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I was in an old farm building underneath another farm building and I couldn’t get out no matter how l tried. I crawled and cut my knees on the straw loosely scattered around my prison. In the distance I could see a very bright light and tried in vain to get to it. My daughter was there crying. I tied her to my back and tried to escape it felt like a scene from the TV show “Criminal Minds”. I shouted out, but nobody came to help me. Then I thought I saw a little red light behind me like the record light on a video recorder. This meant that I was not here alone. I was now scared - roasting hot, thirsty and exhausted.

After what seemed like an age, I managed to get myself and my daughter out of the hellhole. Now I found myself in another strange place, very old fashioned with extremely kind and caring people. We were all there, they told me, to look after the dead people and their families! We washed and dried the bodies and we hugged the bereaved! We fed them and told stories! I knew that I had met these people before but couldn’t remember where or when. The music started and we all held hands and danced in a circle with the stronger lifting the weakest and I felt at peace and cared for – at one with God and those around me.

Then I saw a woman I used to know and she was running a mobile chipper. My daughter was a three year old again and dancing with the tiny tots in their little fairy costumes and the chipper lady was angry and wanted to pour hot oil over the children so I tried to get them away out on to the water. I found myself in a hotel as l searched desperately for my partner, no one had ever heard of him there. But I had a plan - I could remember his telephone number, so after looking through the whole hotel room by room and meeting strange mean people, I spotted a phone. It was an old fashioned gold coloured phone and when I went to lift the receiver I found it was just a prop used in pantomime. I was totally exhausted, sad, scared, lost, lonely and bewildered, then I saw elderly lonely people who needed minding and I thought I could setup a nursing home, but how would I finance it?

I tried to calculate the figures and asked my son and brother in law to help me. Why was I so exhausted, so very hot and thirsty? I couldn‘t get my brain to get to the end of anything. It was like typing on the computer and then pressing delete half way through in error.

Then I felt someone wet my lips. After some more weird experiences, I was aware of finding my partner and my children...

...They explained, slowly, that I had been in an induced coma for 22 days following the removal of a large tumour that had wound its way around my brain. Although l had been diagnosed with vertigo for the last thirty years there had, in fact, been a tumour growing on my brain. Though the operation had successfully removed it, there had been complications during surgery. A bleed in the brain had left me now without my short term memory and without the use of my left arm and leg. There had also been some infection, so they had to go back into my brain to treat the infection six more times. The good news for me was that all of those horrible experiences of being trapped were nightmares I had while in the coma. I had come near to death on a few occasions. They talked to my partner about switching off the life support machine as they couldn‘t foresee just how much damage was done and what I would be like if I survived.

I was confused scared and unable to move in or out of the bed.

That all happened in October 2011 and I was in the hospital in Cork until March 2012. Then I spent ten weeks in the National Rehabilitation Hospital until 9th June 2012. As I write this today two years later, I can’t believe how much my life has changed.

Prior to my surgery I had been employed for 33 years in an insurance office, drove a lovely car, taught speech and drama at the weekends and loved public speaking. I even represented the Insurance Institute

Brainstorm | By Lucy Martin

Lucy was diagnosed over thirty years ago with vertigo. What she didn’t know was that it was caused by a slow growing benign brain tumour. When surgery to remove it had complications, she suffered a bleed which left her in an induced coma for 22 days before she started her recovery. In this piece, Lucy writes about her dreamlike experiences as she emerged from unconsciousness into a journey of recovery which continues today.

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of Ireland in Scotland. I was great at managing my finances, took part in pantomime and plays as an actor and I loved a good night out.

When I came out of the NRH, I was told that I would probably never use my left arm and hand again. They gave me a splint on my left leg to help me walk a little. They were unsure that l would drive again as they felt my left eye may be compromised. I was so glad to be coming home at last after all this but I was lonely, scared and bewildered. Why didn‘t I die? Was there a purpose to all this? How would I manage money-wise? How could an independent healthy non-smoker odd-glass-of-wine-drinker regular-gym-user now survive?

The cleverness of having always saved now meant I wasn‘t entitled to a medical card and if I didn‘t have a medical card, then I wasn’t entitled to home help or even the visit of a Public Health Nurse or any alterations to the house such as railings, bars or shower adjustments.

It was such a scary and depressing time and l was surrounded by love and family and wonderful friends. My partner would often quote his father and tell me not to waste energy asking why? He said that each one of us is dealt our hand of cards and all we have to do is play them, take one little step at a time and then look and see how far we have come.

I had never heard of Headway prior to my surgery and wasn’t quite sure if I needed it or wanted it. But I desperately wanted to be as good as I could be, and thought I would give anything a try.

So my new life began again. Tomorrow morning, I will drive in my new little adapted red car to Headway and meet my good friends with whom I have laughed and cried with over the past two years.

We have had fun nights out, we all participated

in a special “come dine with me” at each of our homes. We have had nights out at the theatre and have been given unbelievable support from all at Headway with no pressure - you are invited into a warm, loving group of people who understand my life and any difficulties I may experience. All I have to do is be ME!

Perhaps Headway’s greatest gift to me was providing me with a weekly appointment with a fabulous psychologist. She saw I was suffering from PTSD (Post Traumatic Stress Disorder). I jumped at every noise, cried at every emotion and was scared - so scared! This week I am coming to the end of my one to one sessions with her and I am now excited about my life and its possibilities. I have become a grandmother to the most beautiful girl (I may be biased, but I think she is the most beautiful, cleverest baby in the whole world!). One of the books that my psychologist gave me to read is titled “When bad things happen to good people” and the writer cries out to God for answers. God sends answers by way of the people we meet on our journey.

I have met wonderful people and even though I don‘t have all the answers now, I have completed a year’s self-development course at SHEP (Social and Health Education Project) and will be doing another year long course in September.

I intend to go back to all those people who perhaps didn‘t have all the great love and support I have and hold their hand and listen and tell them not to ever give up and look out for people that God has sent to meet them on their journey. And when they see an umbrella named Headway over a group of fantastic people, crawl under it, be minded until you can find your wings again.

Thank you to Headway, and to my amazing partner, family and friends. I couldn’t have come this far without you!

Headway Men’s ShedsBy Sara Sabbioni, Headway Dublin Day Services

According to the Irish Men’s Sheds Association, a men’s shed is a “dedicated, friendly and welcoming place where men come together and undertake a variety of mutually agreed activities”

The unique aspect of the Headway Men’s Sheds is that all participants have an acquired brain injury. We believe that the Headway groups are the first Men’s shed groups in Ireland based on the needs of people with Acquired Brain Injury. The first group Headway set up saw the collaboration of

three Headway staff members – myself and two of our Community Reintegration specialists, Kieran McCullagh and Samantha Whelan. We identified a lack in service provisions for male clients who are not interested in engaging in educational session or group discussions or prefer to spend time in the fresh air and working with their hands.

The first group started in June 2014 and it takes place in the Ringsend and Irishtown Community Centre. Currently, six clients are taking part and all attend

Where it all started...... November 2011 during a dinner party with pals and my wife, then, my life changed forever.

I had an accident in my own home and hit my head. After that I can’t remember much. I only know bits of what my wife has told me. I was admitted to hospital with a fractured skull which caused swelling and a

bleed on my brain. After a week in hospital there was another bleed on my brain and was I transferred to Beaumont Hospital. I then spent 4 weeks in a coma. I then spent another 3 months in hospital. During this time I was in denial and believed I was fine. In March 2012 I was transferred to the NRH where I stayed for another 6 months. It was very hard for me. I didn’t know what was going on with me. Then in August 2012 I went to Redwood Care Facility where I stayed for another 9 months. While I was there I didn’t know how to cope following my injury but they gave me

lots of help and support and that got me on the road to recovery.

In April 2013, my journey started with Headway. I began by going to a gardening course where I got to meet others who had acquired a brain injury. I found it a lot easier to manage because the other people and staff could understand how I was feeling. They listened to me and helped me to progress.

I was then offered a place on Headway Rehabilitation Training Programme in Clondalkin, which has helped to give me back my independence. It gives me the opportunity to do something for myself to help with my brain injury. It can be very difficult at times because I do not look like I have an injury. People expect me to be the same as I was but in Headway they understand how I feel and give me reassurance that things can be good again. I also enjoy helping others in the group when I can. I also attend Headway’s Men Shed in Irishtown where I do gardening and painting. With the help of Headway and my wife whom I wish to thank very much, I am on the road to recovery.

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different services in Headway. The clients are presently working on two projects: a mural representing a Viking Vessel which indicates the origin of the area and an allotment. Headway staff have noticed a good bond and collaboration within the group and a collaborative and helpful atmosphere overall. Also, the group has built an excellent partnership with the very helpful staff from the Community Centre. This project has provided all clients with the opportunity to reintegrate back into the community as well as refreshing and acquiring new skills.

We also continued to develop our Men’s Shed Project by launching a second facility in the Bawnogue

Enterprise Park in Clondalkin, Dublin. This project began at the start of October and runs from 10am to 1pm each Friday. All men living in the local area are welcome to join this group to offer their expertise and avail of the opportunity to participate in projects while building new friendships. All projects will be planned and delivered in collaboration with the men attending the group with the support of Headway and Action Community Enterprise.

A group from the Headway Men’s sheds attended the Irish Men Shed Association National Conference on the 4th of October in the Helix in DCU where they met President Michael D. Higgins.

Where it all started...By Thomas Jackson

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Research Roundup: Anxiety After Brain InjuryIndividual wellbeing depends on many factors. Severe anxiety following brain injury creates a barrier to wellbeing that has been well researched. In this edition of Research Roundup, Headway Assistant Psychologist Niamh Lowe examines three pieces of research in the area

Anxiety disorders following brain injury are widely reported in research literature. People with severe anxiety can have recurring intrusive thoughts or worries. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness or a rapid heartbeat. We don’t know exactly what causes anxiety, but one theory suggests that a combination of direct biological factors and indirect factors such as environment and personal history play a role. This is the so-called biopsychosocial model.

Soo, C., & Tate, R. (2012). Psychological treatment for anxiety in people with traumatic brain injury (review). Cochrane Database Syst Rev, 3.

This review discusses previous trials in the area of psychological treatments for anxiety after ABI. They argue that the use of pharmacological approaches in the management of anxiety, in this population, creates an increased risk of medical side effects (for example, nausea, dizziness and insomnia). Cognitive side effects of pharmacological treatments (for example, slowed information processing speed) have also been reported. These side effects may further reduce already weakened cognitive functioning. They propose that psychological treatments may be preferable during the initial phase of anxiety treatment.

In their review, the authors found evidence for the effectiveness of the following interventions: cognitive behavioural therapy (CBT) for treatment of acute stress disorder following mild TBI, and combining CBT and neurorehabilitation for treatment of general anxiety symptoms in individuals with mild to moderate TBI.

Hsieh, M. Y., Ponsford, J., Wong, D., Schönberger, M., McKay, A., & Haines, K. (2012). A cognitive behaviour therapy (CBT) programme for anxiety following moderate-severe traumatic brain injury (TBI): Two case studies. Brain Injury, 26(2), 126-138.

An argument for psychological treatments is also made in this article. The authors outline that psychological treatments teach adaptive coping skills which, if adopted, may produce longer-lasting effects than medication and promote self-efficacy and independence. They also highlight the potential benefits of psychological treatments by outlining that post-ABI anxiety is often maintained and worsened by psychosocial factors (e.g. ineffective coping and social isolation) which emerge

during the process of community reintegration.

The authors promote the use of cognitive behavioural therapy (CBT) in the treatment of anxiety in survivors of ABI. CBT is a well-researched and structured psychological therapy based on the idea that emotional problems can be effectively managed using adaptive thinking and behavioural strategies. An advantage of this therapy is that, given the highly structured content, it is open to adaptation for memory, attention and problem solving impairments, corresponding to common difficulties experienced by people with brain injury.

This study aimed to: (1) illustrate, through two client cases, CBT’s potential in addressing anxiety problems following ABI, and (2) document the process of implementing a CBT programme specifically adapted for this client group.

The two clients with ABI showed a reduction in measures of anxiety and of distress. The two client cases suggest that the structured yet flexible nature of CBT can lend itself well to alterations for an ABI population. This paper provided examples of how CBT could be changed to accommodate cognitive impairments, while also highlighting the need to consider the individual’s preferences and the characteristics of their personality.

Williams, W. H., Evans, J. J., and Fleminger, S. (2003). Neurorehabilitation and cognitive-behaviour therapy of anxiety disorders after brain injury: An overview and a case illustration of obsessive-compulsive disorder. Neuropsychological Rehabilitation, 13(1-2), 133-148.

Neurorehabilitation works with the skills and attributes of the person with a disability and supports them in achieving meaningful goals. Neurorehabilitation and CBT both have an emphasis on enabling survivors to gain skills, record progress, challenge pessimism, and promote self-efficacy.

This paper illustrates how Neurorehabilitation, in combination with CBT, provides strategies for understanding and managing cognitive and emotional disorders for brain injury survivors. The paper shows how strategies from each discipline can be developed to work together with the other. It reveals that this combination of techniques can help to reduce anxiety in survivors of ABI.

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Contact InformationHead Office and Dublin Rehabilitation CentreBlackhall Green, Off Blackhall Place, Dublin 7Tel: (01) 604 0800 Fax: (01) 604 1700Web: www.headway.ie Email: [email protected] Training & Day Rehabilitative Services, Employment Support, Community Reintegration, Neuropsychological Assessment, Psychotherapy, Counselling and Information & Support.

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Making Headway Autumn/Winter 2014